Sherif Rami D, Massenburg Benjamin B, Weissler E Hope, Jabs Ethylin Wang, Taub Peter J
*Division of Plastic and Reconstructive Surgery, Department of Surgery †Department of Pediatrics, Department of Genetics and Genomic Sciences, Department of Developmental and Regenerative Biology ‡Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
J Craniofac Surg. 2016 Sep;27(6):1506-9. doi: 10.1097/SCS.0000000000002878.
Smile Train is a charitable organization that partners with and trains surgeons in developing countries to provide surgical care to patients with cleft lip/palate deformities. The organization supports surgeries in several countries that experience high levels of regional conflict and violence. Nigeria, a country where Smile Train is very active, has undergone numerous periods of extreme violence over the past 12 years. The purpose of the present study is to analyze how local violence and conflict have impacted the ability of surgeons partnered with Smile Train to provide care in Nigeria.
The authors retrospectively reviewed Smile Train Express, the organization's database, from 2003 to 2015 for cleft lip/palate repairs performed in Nigeria. The data was chronologically mapped against a detailed timeline of incidents of violence in Nigeria to compare how violence affected the work of Smile Train-affiliated surgeons.
Smile Train-affiliates facilitated 11,499 surgeries in Nigeria from 2003 to 2015. During the same period, 46,370 people were killed in Nigeria in acts of terrorism and violence. Major drops in the frequency of cleft surgeries were preceded by spikes in violence.
Violence in Nigeria has had a clear impact on the ability of Smile Train-affiliated surgeons to provide adequate cleft care. The international medical community needs to take steps in an attempt to continue to provide essential medical care in areas of conflict and instability.
“微笑列车”是一个慈善组织，它与发展中国家的外科医生合作并对其进行培训，为唇腭裂畸形患者提供外科治疗。该组织在一些地区冲突和暴力频发的国家支持开展手术。尼日利亚是“微笑列车”非常活跃的一个国家，在过去12年里经历了多次极端暴力时期。本研究的目的是分析当地的暴力和冲突如何影响与“微笑列车”合作的外科医生在尼日利亚提供治疗的能力。
作者回顾性分析了“微笑列车”组织2003年至2015年的数据库“微笑列车快报”，以获取在尼日利亚进行的唇腭裂修复手术信息。这些数据按照时间顺序与尼日利亚暴力事件的详细时间表进行比对，以比较暴力如何影响与“微笑列车”相关的外科医生的工作。
2003年至2015年期间，与“微笑列车”相关的人员在尼日利亚协助进行了11499例手术。同一时期，尼日利亚有46370人在恐怖主义和暴力行为中丧生。暴力事件激增之前，唇腭裂手术的频率会大幅下降。
尼日利亚的暴力事件对与“微笑列车”相关的外科医生提供足够的唇腭裂治疗的能力产生了明显影响。国际医学界需要采取措施，试图在冲突和不稳定地区继续提供基本医疗服务。
